Generic Name: Pentostatin
Pentostatin is the generic name for the trade name drug Nipent. In some cases, health care professionals may use the trade name Nipent when referring to the generic drug name pentostatin.
Drug Type: Pentostatin is an anti-cancer ("anti-neoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "antimetabolite." (For more details, see "How this drug works" section below).
What Pentostatin Is Used For
- This medication is used in the treatment of hairy cell leukemia.
- Off-label uses:
- Acute graft-versus-host disease (treatment)
- Chronic graft-versus-host disease, steroid refractory (treatment)
- Chronic lymphocytic leukemia
- Cutaneous T-cell lymphomas, mycosis fungoides/Sezary syndrome
- T-cell prolymphocytic leukemia, refractory
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How Pentostatin Is Given
- This medication is given by infusion through a vein (intravenously, by IV).
- It can be given by IV over 20 to 20 minutes or as a bolus.
- Hydrate before and after infusion.
- There is no pill form of this medication.
- The amount of pentostatin that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.
Important things to remember about the side effects of pentostatin:
- Most people will not experience all of the pentostatin side effects listed.
- Pentostatin side effects are often predictable in terms of their onset, duration and severity.
- Pentostatin side effects will improve after therapy is complete.
- Pentostatin side effects may be quite manageable. There are many options to minimize or prevent the side effects of pentostatin.
The following side effects common (occurring in greater than 30%) for patients taking pentostatin:
- Nausea and vomiting
- Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding.
- Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.
- Nadir: 7 days
- Recovery: 10-14 days
- Skin rash - dry and pruritic
These are less common (occurring in 10-29%) side effects for patients receiving pentostatin:
Serious but uncommon side effects can occur when giving higher than recommended doses such as CNS toxicity (confusion, seizures, memory problems, and cognitive problems), liver damage, decreasing lung function and breathing problems, and kidney damage.
Not all side effects are listed above. Side effects that are very rare - occurring in less than about 10 percent of patients - are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.
When To Contact Your Doctor or Health Care Provider
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
- Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
- Shortness of breath, difficulty breathing
The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:
- Nausea (interferes with ability to eat and unrelieved with prescribed medication).
- Vomiting (vomiting more than 4-5 times in a 24-hour period).
- Diarrhea (4-6 episodes in a 24-hour period).
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools
- Blood in the urine
- Pain or burning with urination
- Extreme fatigue (unable to carry on self-care activities)
- Mouth sores (painful redness, swelling or ulcers)
Always inform your health care provider if you experience any unusual symptoms.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
- You may be at risk of infection so try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Follow regimen of anti-diarrhea medications as prescribed by your health care professional.
- Eat foods that may help reduce diarrhea
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
- Avoid sun exposure. Wear SPF 30 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your health care provider.
- Get plenty of rest.
- Maintain good nutrition.
- If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
Monitoring and Testing While Taking Pentostatin
You will be checked regularly by your doctor while you are taking pentostatin, to monitor side effects and check your response to therapy. Periodic blood work will be obtained to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
How Pentostatin Works
Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue. "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition. Cancerous cells lose this ability. Cancer cells no longer have the normal checks and balances in place that control and limit cell division. The process of cell division, whether normal or cancerous cells, is through the cell cycle. The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on its ability to halt cell division. Usually, the drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cells are unable to divide, they die. The faster the cells are dividing, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle specific. Chemotherapy drugs that affect cells when they are at rest are called cell-cycle non-specific. The scheduling of chemotherapy is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing. Unfortunately, chemotherapy does not know the difference between the cancerous cells and the normal cells. The "normal" cells will grow back and be healthy but in the meantime, side effects occur. The "normal" cells most commonly affected by chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body.
Pentostatin belongs to the class of chemotherapy drugs called antimetabolites. Antimetabolites are very similar to normal substances within the cell. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are cell-cycle specific. They attack cells at very specific phases in the cycle. Antimetabolites are classified according to the substances with which they interfere. Pentostatin is classified as an adenosine deaminase inhibitor.
Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.
- Nipent (pentostatin) [prescribing information]. Lake Forest, II: Hospira, Inc.; May 2015.
- Pentostatin: Lexicomp Online® [September 1, 2016; September 13, 2016]. Hudson, Ohio. Lexi-Comp, Inc.; September 13, 2016.